COVID-19 Has Changed Patient-Clinician Communication: What Can Rehabilitation Professionals Do to Enhance It?
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RESPONSE TO COVID-19/COMMENTARY
COVID-19 Has Changed Patient-Clinician Communication: What Can Rehabilitation Professionals Do to Enhance It? Cara Ann Senicola, PT, DPT, OCS, CYT
& Jerome
Brent Smith, PT, DPT & Katherine Wilson, PT, DPT
Received: 2 June 2020/Accepted: 8 September 2020 / Published online: 13 November 2020 * Hospital for Special Surgery 2020
Keywords
COVID-19 . Communication . Rehabilitation
Introduction Imagine yourself as a patient in the following three scenarios. Scenario 1: You wake up in a noisy, bright room with a tube in your mouth and dozens of lines connecting you to various machines. You are terrified of the beings surrounding you, who look like aliens. What you do not remember is that you were admitted to an intensive care unit (ICU), that the “aliens” are healthcare providers in personal protective equipment (PPE), and that you are very ill with COVID-19. You desperately look around for your loved ones, but they are nowhere to be found. Scenario 2: You underwent a total knee replacement on March 20, 2020, 2 days before the New York State shutdown in response to the COVID-19 pandemic. Having been discharged home, you are now eager to begin rehabilitation. Being post-operative, you are deemed an “essential” patient. The outcome of the surgery is highly dependent on early post-operative knee range of motion and swelling, and these are ideally assessed and treated during an in-person physical therapy session. After interrogating your physical therapist (PT) about the safety measures the hospital has undertaken, you decide to travel 90 min to your first appointment. When you arrive, you realize your extreme discomfort with the post-operative care that requires close proximity and Supplementary information The online version of this article (https://doi.org/10.1007/s11420-020-09802-3) contains supplementary material, which is available to authorized users. C. A. Senicola, PT, DPT, OCS, CYT (*) : J. B. Smith, PT, DPT : K. Wilson, PT, DPT Hospital for Special Surgery, 535 E. 70th St, New York, NY, USA e-mail: [email protected]
physical touch by a stranger clearly not within current social distance guidance of 6 ft. Scenario 3: You are working at home while being treated for back pain and you have scheduled a 30-min telehealth physical therapy visit on your lunch break during a hectic workday. Your husband is caring for your three school-age kids while acting as their teacher in your home. When first attempting to connect with the PT on your computer, you see only a blank screen. You phone the PT, who asks you to leave the session and reconnect; the PT’s face becomes visible, but she says that your screen keeps freezing. Frustrated and in pain, you leave the session and try to reconnect once more. For public safety, rehabilitation has shifted to treating patients through telehealth or in person while wearing personal protective equipment (PPE). This allows a connection with patients but with several constraints. As the opening scenarios illustrate, the loss of non-verbal communication coupl
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